19-Manor ISD Large Claim Reporting 9.2023-12.2025.xlsx

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Attached to
Manor ISD - 2026 Medical RFP
Solicitation number
26-008RFP
Issued by
Travis County, Texas

About this file

Written by GovTribe AI ·

This file contains a Large Claim Reporting spreadsheet for Manor Independent School District's health insurance claims data, corresponding to the district's 2026 Medical RFP for Self-Funded Medical and Prescription Drug Plans, Fully Insured Medical and Prescription Drug Plans, and Stop Loss Products. The report documents high-cost claimant information across three distinct periods: September 2023 through August 2024, September 2024 through August 2025, and September 2025 through December 2025. The data includes encrypted member identifiers, member relationship classifications (subscriber, spouse, dependent child), primary diagnoses, medical paid amounts, pharmacy paid amounts, and total paid claims for each claimant exceeding the specified high-cost thresholds ($50,000 for the first two periods and $25,000 for the most recent period).

The claims data reveals significant healthcare expenditures across the three reporting periods, with total paid claims of $3,627,737.63 (2023-2024, 26 claimants), $6,042,070.21 (2024-2025, 44 claimants), and $2,572,909.85 (2025, 28 claimants). Medical services and pharmacy costs are tracked separately, with pharmacy claims representing a substantial portion of total expenditures. High-cost conditions documented include chronic renal failure, factor VIII deficiency, respiratory failure, spinal muscular atrophy, and various malignant neoplasms. This claims data serves as critical historical information for vendors responding to Manor ISD's RFP, enabling them to assess the district's healthcare cost profile and develop accurate proposals for the medical and stop loss coverage requested. Proposals must be submitted to Chrissie Bryant, Purchasing Coordinator, at Purchasing@manorisd.net through the Euna portal.

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Dynamic Claimant

Run Date: 2/2/2026

Metrics:(Paid)
High Cost Threshold:($50,000)
Paid Month:(Sep 2023 - Aug 2024)
Service Category:(FACILITY INPATIENT, FACILITY OUTPATIENT, PROFESSIONAL, PHARMACY)
Encrypted Member IDMember Relationship DescriptionPrimary DiagnosisMedical PaidPharmacy PaidPaid
8121977297585047996SubscriberN13 - Obstructive and reflux uropathy6,216.03688,541.34694,757.37
6019531012974920390SubscriberD66 - Hereditary factor VIII deficiency288.97430,927.57431,216.54
6694979315554783862SubscriberG11 - Hereditary ataxia2,376.21182,763.31185,139.52
750627336464263391Dependent ChildJ96 - Respiratory failure, not elsewhere classified180,545.2393.94180,639.17
2084185188054031654Dependent ChildZ99 - Dependence on enabling machines and devices, not elsewhere classified162,028.092,327.71164,355.80
6202999279817841740Dependent ChildG12 - Spinal muscular atrophy and related syndromes14,986.85141,527.11156,513.96
8024443307166921423SubscriberF33 - Recurrent depressive disorder760.14139,768.62140,528.76
1833441812165753896SpouseI48 - Atrial fibrillation and flutter129,715.56189.02129,904.58
9084580838516477225SubscriberS06 - Intracranial injury123,515.1692.26123,607.42
6751179035126078788SubscriberT79 - Certain early complications of trauma, not elsewhere classified121,387.8624.11121,411.97
4063990446913588251SubscriberM48 - Other spondylopathies120,607.530.00120,607.53
8962028849723391775SpouseN18 - Chronic renal failure107,532.575,878.75113,411.32
8338872174721189843SubscriberN18 - Chronic renal failure111,369.71194.23111,563.94
4260479979709139910Dependent ChildF84 - Pervasive developmental disorders107,952.880.00107,952.88
2288214574400101860SubscriberC50 - Malignant neoplasm of breast103,673.480.52103,674.00
596791702527343279SubscriberK56 - Paralytic ileus and intestinal obstruction without hernia98,293.46511.9698,805.42
2329613266373177380SubscriberG35 - Multiple sclerosis78,858.676,089.2184,947.88
6104682396989871739SubscriberE11 - Non-insulin-dependent diabetes mellitus75,770.958,364.7284,135.67
2281913569062466753SubscriberK50 - Crohn's disease [regional enteritis]80,773.0674.5080,847.56
8966914933626482288SubscriberZ47 - Other orthopaedic follow-up care68,064.5646.0668,110.62
7842575415443208980SubscriberJ02 - Acute pharyngitis1,207.7456,837.8758,045.61
4657789646815587468SubscriberE11 - Non-insulin-dependent diabetes mellitus45,229.1011,691.0556,920.15
1022989748571435009SubscriberM47 - Spondylosis26,746.9927,577.3654,324.35
7229027485593804546SubscriberH25 - Senile cataract10,083.3943,538.9953,622.38
2035088239631082052Dependent ChildS83 - Dislocation, sprain and strain of joints and ligaments of knee52,164.190.0952,164.28
7720245251222040841SubscriberC50 - Malignant neoplasm of breast50,366.13162.8250,528.95
Query Totals: 261,880,514.511,747,223.123,627,737.63
Report Totals: 261,880,514.511,747,223.123,627,737.63

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Dynamic Claimant

Run Date: 2/2/2026

Metrics:(Paid)
High Cost Threshold:($50,000)
Paid Month:(Sep 2024 - Aug 2025)
Service Category:(FACILITY INPATIENT, FACILITY OUTPATIENT, PROFESSIONAL, PHARMACY)
Encrypted Member IDMember Relationship DescriptionPrimary DiagnosisMedical PaidPharmacy PaidPaid
8121977297585047996SubscriberN20 - Calculus of kidney and ureter15,119.39742,133.99757,253.38
6019531012974920390SubscriberD66 - Hereditary factor VIII deficiency955.50737,634.91738,590.41
4730270440619251948Dependent ChildS31 - Open wound of abdomen, lower back and pelvis256,554.1749,614.46306,168.63
3540626754665935764SubscriberI27 - Other pulmonary heart diseases212,345.6010,555.74222,901.34
8050512952950000800SubscriberI13 - Hypertensive heart and renal disease212,906.08529.67213,435.75
2084185188054031654Dependent ChildZ99 - Dependence on enabling machines and devices, not elsewhere classified204,633.052,611.64207,244.69
6694979315554783862SubscriberK52 - Other noninfective gastroenteritis and colitis5,954.05191,528.31197,482.36
2051142487552405999SubscriberM17 - Gonarthrosis [arthrosis of knee]191,244.290.00191,244.29
8024443307166921423SubscriberF41 - Other anxiety disorders4,166.93154,800.15158,967.08
1183455891590386660Dependent ChildF84 - Pervasive developmental disorders158,339.4713.96158,353.43
8031728697412293953SubscriberZ12 - Special screening examination for neoplasms5,662.79140,838.52146,501.31
8962028849723391775SpouseN18 - Chronic renal failure134,339.767,495.64141,835.40
4085222615939855331Dependent ChildM41 - Scoliosis125,061.3434.51125,095.85
4813801640415999501SubscriberM34 - Systemic sclerosis32,765.9490,499.09123,265.03
2318108370334176448SpouseS72 - Fracture of femur106,708.4014,628.18121,336.58
6015331077374705708SubscriberI21 - Acute myocardial infarction117,270.12106.29117,376.41
8338872174721189843SubscriberN18 - Chronic renal failure116,761.70337.66117,099.36
6202999279817841740Dependent ChildN13 - Obstructive and reflux uropathy109,693.251,479.66111,172.91
2454263806829419801Dependent ChildZ38 - Liveborn infants according to place of birth102,071.870.00102,071.87
4941942740942695051SubscriberZ00 - General examination and investigation of persons without complaint and reported diagnosis2,953.1495,211.4198,164.55
992742092960348498SubscriberM17 - Gonarthrosis [arthrosis of knee]95,283.792.8195,286.60
8966914933626482288SubscriberM48 - Other spondylopathies92,565.4185.4592,650.86
1022989748571435009SubscriberG72 - Other myopathies50,032.6442,411.7492,444.38
5679748281664628921SubscriberN63 - Unspecified lump in breast997.1587,047.8688,045.01
7990076309536265890SubscriberN18 - Chronic renal failure80,433.695,284.5685,718.25
1833441812165753896SpouseT84 - Complications of internal orthopaedic prosthetic devices, implants and grafts84,320.12545.0884,865.20
877827675119157590SpouseS83 - Dislocation, sprain and strain of joints and ligaments of knee77,673.726,966.7684,640.48
8409020142748461106SubscriberM17 - Gonarthrosis [arthrosis of knee]80,452.06589.6581,041.71
8645422814304097038SubscriberM17 - Gonarthrosis [arthrosis of knee]72,528.15257.8372,785.98
3409680996098973554Dependent ChildZ38 - Liveborn infants according to place of birth70,040.190.0070,040.19
2747352007883586930SubscriberI47 - Paroxysmal tachycardia69,551.9713.7469,565.71
7229027485593804546SubscriberE11 - Non-insulin-dependent diabetes mellitus17,083.9051,407.5168,491.41
3346473487603701972SubscriberI47 - Paroxysmal tachycardia61,496.191,740.6263,236.81
2953068296915260253SubscriberM48 - Other spondylopathies61,383.471,819.1563,202.62
164592947249935622SubscriberT81 - Complications of procedures, not elsewhere classified61,354.884.6561,359.53
6104682396989871739SubscriberJ18 - Pneumonia, organism unspecified49,662.3311,690.7261,353.05
4657789646815587468SubscriberG45 - Transient cerebral ischaemic attacks and related syndromes48,273.6612,740.9961,014.65
4649273315827035471SubscriberM17 - Gonarthrosis [arthrosis of knee]56,312.963,752.0460,065.00
8054861092823446254SubscriberN92 - Excessive, frequent and irregular menstruation59,886.9037.1259,924.02
7842575415443208980SubscriberH20 - Iridocyclitis2,643.7955,843.3058,487.09
8834158870683300829SubscriberK42 - Umbilical hernia5,850.6950,529.9056,380.59
2483883075167407104SubscriberI48 - Atrial fibrillation and flutter52,127.91918.0953,046.00
5536937804799822211SubscriberM76 - Enthesopathies of lower limb, excluding foot52,176.5611.6152,188.17
2329613266373177380SubscriberG35 - Multiple sclerosis47,474.313,201.9650,676.27
Query Totals: 443,465,113.282,576,956.936,042,070.21
Report Totals: 443,465,113.282,576,956.936,042,070.21

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Dynamic Claimant

Run Date: 2/2/2026

Metrics:(Paid)
High Cost Threshold:($25,000)
Paid Month:(Sep 2025 - Dec 2025)
Service Category:(FACILITY INPATIENT, FACILITY OUTPATIENT, PROFESSIONAL, PHARMACY)
Encrypted Member IDMember Relationship DescriptionPrimary DiagnosisMedical PaidPharmacy PaidPaid
4730270440619251948Dependent ChildS37 - Injury of pelvic organs463,965.4515,900.98479,866.43
6019531012974920390SubscriberM19 - Other arthrosis37,672.39336,971.00374,643.39
8050512952950000800SubscriberA41 - Other septicaemia248,465.3312.08248,477.41
2084185188054031654Dependent ChildZ99 - Dependence on enabling machines and devices, not elsewhere classified49,374.97167,838.91217,213.88
4255850521043393881Dependent ChildZ38 - Liveborn infants according to place of birth116,222.400.00116,222.40
532965161068767555SubscriberM50 - Cervical disc disorders105,671.89376.50106,048.39
4212468029815085983SubscriberI67 - Other cerebrovascular diseases103,054.550.00103,054.55
2288214574400101860SubscriberC50 - Malignant neoplasm of breast68,387.621,667.2870,054.90
8121977297585047996SubscriberN20 - Calculus of kidney and ureter2,249.4864,853.1167,102.59
6956989340538076877SubscriberD05 - Carcinoma in situ of breast61,994.531,149.5063,144.03
1183455891590386660Dependent ChildF84 - Pervasive developmental disorders61,014.9764.4261,079.39
8962028849723391775SpouseN18 - Chronic renal failure49,852.402,300.3652,152.76
687746626053470590SubscriberC50 - Malignant neoplasm of breast50,647.6053.7950,701.39
4657789646815587468SubscriberI16 - Hypertensive crisis45,267.654,704.1149,971.76
8024443307166921423SubscriberL03 - Cellulitis443.3947,277.1647,720.55
4813801640415999501SubscriberM34 - Systemic sclerosis12,243.2330,971.3243,214.55
2329613266373177380SubscriberG35 - Multiple sclerosis41,031.311,984.0743,015.38
8294714847898579486SubscriberJ32 - Chronic sinusitis41,500.270.0041,500.27
8651063155326295056SubscriberM16 - Coxarthrosis [arthrosis of hip]37,209.023,479.3340,688.35
6202999279817841740Dependent ChildE43 - Unspecified severe protein-energy malnutrition9,684.0628,187.3737,871.43
283690822150018453SubscriberA41 - Other septicaemia35,823.31873.9836,697.29
6104682396989871739SubscriberT81 - Complications of procedures, not elsewhere classified36,005.700.0036,005.70
8338872174721189843SubscriberN18 - Chronic renal failure34,429.05105.2734,534.32
6672715074505954875SubscriberZ23 - Need for immunization against single bacterial diseases795.8032,163.0732,958.87
4941942740942695051SubscriberZ00 - General examination and investigation of persons without complaint and reported diagnosis1,044.7030,173.6831,218.38
6849153654071089498Dependent ChildJ96 - Respiratory failure, not elsewhere classified30,696.180.0030,696.18
6341165288982509909SubscriberO42 - Premature rupture of membranes29,665.97505.9930,171.96
1703898883421554585Dependent ChildQ89 - Other congenital malformations, not elsewhere classified26,738.97144.3826,883.35
Query Totals: 281,801,152.19771,757.662,572,909.85
Report Totals: 281,801,152.19771,757.662,572,909.85

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